For many, anxiety is an ever-present uninvited guest; in our circle of friends, among family members, and in communities at large.
It seems to be rampaging through society like a noncontagious cognitive plague, forming a low-level hum that hides in the corners of our collective minds.
In August 2018, Barnes & Noble — who are the largest book retailer in the United States — announced a huge surge in the sales of books about anxiety; a 25 percent jump on June 2017. “[W]e may be living in an anxious nation,” one press release dryly notes.
Does this surge in interest reflect a genuine spike in anxiety, or are people simply more aware of it? In this article, we ask whether anxiety truly is increasing, if wealthier nations are bearing the brunt, and why anxiety seems to be sitting in the driving seat of modern society.
Many of us — a surprisingly high percentage, as we shall see — are all too familiar with how anxiety feels. For those who have not experienced anxiety first-hand, throughout the text, we have added excerpts from personal experiences.
What is anxiety?
Anxiety is a nebulous term that covers a great deal of psychological ground. At the thinnest end of the wedge, before an exam or a job interview, we might feel anxious. This is both understandable and normal; it is not a cause for concern.
Anxiety is only a problem when it extends beyond logical worry in an unreasonable, unwarranted, uncontrollable way. Situations that should elicit no negative emotions all of a sudden seem life-threatening or crushingly embarrassing.
At the widest end of the wedge, anxiety can arrive as a symptom of another mental illness, such as panic disorders, post-traumatic stress disorder, phobias, or obsessive-compulsive disorder (OCD).
When anxiety is a person’s primary symptom, it may be referred to as generalized anxiety disorder (GAD). The National Health Service (NHS) in the United Kingdom summarize GAD neatly.
“People with GAD,” they explain, “feel anxious most days and often struggle to remember the last time they felt relaxed. As soon as one anxious thought is resolved, another may appear about a different issue.”
GAD affects around 6.8 million people in the U.S. — or more than 3 percent of the country’s adults.
Another common form of anxiety is social anxiety, which affects people more specifically in social situations.
It might make someone very self-conscious, perhaps not wanting to eat or drink in front of others, fearing that people are talking about them, or worrying about being lost in a crowd. It comes in many forms.
Today, “anxiety disorders are the most common mental illness in the U.S.,” affecting around 40 million adults — almost 1 in 5 people.
Globally, the World Health Organization (WHO) say that almost 300 million people have an anxiety disorder.
Anxiety disorders are not new, either. In fact, Robert Burton wrote this description in The Anatomy of Melancholy (1621) referring to a patient of Hippocrates. It will resonate with anyone who has ever experienced anxiety.
“He dare not come into company for fear he should be misused, disgraced, overshoot himself in gestures or speeches, or be sick; he thinks every man observeth him.”
Interestingly, anxiety is not just a human experience, and evolution is ultimately to blame (or thank); as with other animals, humanity’s survival relies on our natural ability to feel anxious about genuinely dangerous situations and to be on guard.
It is when this life-saving mechanism is triggered at inappropriate times or gets stuck in the “on” position that it becomes a problem.
So, to the first big question: is anxiety really affecting us more now than it has in the past? Is anxiety on the up in the West, or, in a modern society where good mental health is a goal in itself, are we just more likely to notice and discuss it?
“When it’s bad, it feels like an electric current building up inside of me and like it’s going to start shooting out of me, except it doesn’t, which is worse.”
Is anxiety more prevalent in the West?
A large study that was published in the journal JAMA Psychiatry in 2017 set out to answer this exact question. In particular, the researchers looked at GAD.
One might expect that, since mental illness tends to be more common in areas of the U.S. that have a lower socioeconomic status, anxiety might also be more prevalent in countries with a lower socioeconomic profile.
Additionally, in less wealthy countries, people can be under substantial stress; finding food, water, or safety might be an issue in some regions.
However, it is important to remember that GAD is about feelings of anxiety that are unreasonable. In a country where there is genuine struggle, higher levels of anxiety might rightly be considered justifiable and therefore not a diagnosable condition.
The study, involving 147,261 adults from 26 countries, concluded:
“The disorder is especially common and impairing in high-income countries despite a negative association between GAD and socioeconomic status within countries.”
In other words, within each country, GAD is more prevalent in less wealthy regions. However, as a whole, it is the residents of wealthier countries who are more likely to experience GAD, and their lives are more significantly impacted by it.
Breaking down the statistics, the scientists found that lifetime estimates for GAD were as follows:
- low-income countries: 1.6 percent
- middle-income countries: 2.8 percent
- high-income countries: 5.0 percent
This is in line with other research that found a higher prevalence of anxiety in wealthier economies.
In the WHO’s Depression and Other Common Mental Disorders Global Health Estimates report that was released in 2017, they compare prevalence estimates of mental disorders across global regions.
When they compare the levels of depression, no single area has significantly higher rates. When it comes to anxiety disorders, however, it’s a different story; the Americas are head and shoulders above all other regions, including Africa and Europe.
Interestingly, though the U.S. and the West in general do seem to be taking the lead in the anxiety stakes, it may not stay this way for long; the very same report explains that common mental health disorders are increasing in lower-income countries “because the population is growing and more people are living to the age when depression and anxiety most commonly occurs.”
Added to this, anxiety tends to be less common in older adults. Also, because the average age of U.S. individuals is slowly rising, the percentage of people with anxiety disorders may gradually decline.
To conclude this section, although other countries might be catching up, it does seem that anxiety is more common in wealthier nations and perhaps the U.S. in particular — but is it getting worse?
“Anxiety is mysterious. It can feel like an invisible cage that keeps you prisoner on your sofa, unable to move for fear of something that you can’t quite identify.”
Is anxiety increasing in the U.S.?
Much debate surrounds this question. Is anxiety on the rise, or are we simply more inclined to think and speak about it these days? This is a tough question to pick apart, but we must try.
The American Psychiatric Association ran a poll on 1,000 U.S. residents in 2017, and they found that nearly two thirds were “extremely or somewhat anxious about health and safety for themselves and their families and more than a third are more anxious overall than last year.”
They also noted that millennials were the most anxious generation.
In 2018, the same poll was repeated. Anxiety was shown to have risen again by another 5 percent.
Millennials were revealed to still be the most anxious generation.
It is crucial to remember, though, that increasing feelings of anxiety do not equate to a diagnosis of anxiety disorder.
Naturally, it is possible to feel more anxious than you previously did without it being classified as a mental condition.
Looking at the broader picture, several studies have charted the rise of mental health issues in the West.
For instance, a meta-analysis published in 2010 took data from studies that included over 77,000 young people; the scientists found generational increases in mental health issues in 1938–2007.
Another report, using data from four surveys completed by almost 7 million people in the U.S., concluded that “Americans reported substantially higher levels of depressive symptoms, particularly somatic symptoms, in the 2000s–2010s compared to the 1980s–1990s.”
Outside of the U.S., the U.K. Council for Psychotherapy published a report in 2017 that assessed the mental health of full- and part-time employees. Their figures show that “workers reporting anxiety and depression have risen by nearly a third in the last 4 years.”